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Labourers at high risk of TB

Three years have passed since Deepak Nepali (Darji), 35, of Dhulabari, Mechinagar 1, was diagnosed with Tuberculosis (TB). A carpenter by profession, Deepak took the medications prescribed by doctors until he felt better and thought he no longer needed to take full course of the medicine. But soon after discontinuing TB medication and getting back to his daily drudgery, he was again diagnosed with TB.

The sole breadwinner of a family of six, his work as a carpenter requires hard labour. “I did not know that the risks of hard labour could prove so dangerous for the disease I am afflicted with. But the problem is that if I don’t work, my family would have to sleep on empty stomach,” Deepak lamented.

Following the recurrence of the disease, doctors have been treating him under DOTS (directly observed treatment, short-course) process. According to doctors, the medicines Deepak had been taking before for the disease are now ineffective as the virus has become drug resistant. Therefore, Deepak had to be treated with a stronger dose of medicines.

Due to his difficult financial situation, Deepak can not afford to take a rickshaw to make a two kilometres journey to the Primary Health Center at Dhulabari and is compelled to walk under the scorching heat every day to reach the center where he is currently being treated under the DOTS process. Similar is the situation of Anil Pariyar, 18, of Mechinagar-1 who has also been taking TB medications on a regular basis for the past five months.

Meanwhile, the majority of people suffering from TB in the district are said to belong to disadvantaged Dalit community. Both Deepak and Anil also belong to the same low-caste Dalit community. Dalits living in the urban areas in the district are also aware of the disease and the risk it poses to their health. However, due to their poor financial situation and also negligence towards their health, most of TB patient from this community soon become ‘dropouts’ - a term used for those not taking the full course of TB medication. According to the records maintained by the Primary Health Center, Mechinagar, a whooping 37 percent of the total 185 patients who were under medications for the disease in the current fiscal year belong to the Dalit community. According to doctors, hard labour and the tendency to smoke and drink at the end of the day were the major factor behind Dalits as well as other manual workers being prone to the disease.

Due to poverty and illiteracy, the disease has been thriving in impoverished areas and communities. As per the data of the District Public Health Office, the number of patients suffering from TB in the district last year stood at 1,339. Although the figure has shrunk down a bit this year, most of the patients belong to Dalit and other impoverished communities.

Claiming that the number had shrunk a little due to the regular intake of the medicines by the patients. During the fiscal year 2069/70 BS, the number of dropouts was five, while the number is four this year. However, it is estimated that the number of Dalits with TB throughout Jhapa might be higher than 20,000, with 5,000 of them residing in Mechinagar alone.

Meanwhile, PHC in-charge Dr Raju Sedhai said the immunity of the body becomes low when one does not receive enough diet after a day of hard labour.

“Hence, Dalits and other impoverished communities are in higher risk of contracting the disease,” Sedhai said.

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